Before Match
For MS4s and anyone about to start residency.
3 questions- Should I get disability insurance before residency starts?Not before you've done three things: find out where you matched, find out whether there's a GSI policy at that hospital, and find an insurance professional who can offer you both the GSI policy and a medically underwritten one.
- How much does disability insurance cost for a resident or fellow?As a budgeting rule of thumb, around $100 a month, give or take, should get a resident or fellow around 30 years old a foot in the door on a policy.
- Is disability insurance more expensive in California?Usually, yes. Insurance pricing and wording are regulated state by state, and California is the state that stands out for higher pricing, modified policies, or both.
GSI policies
Guaranteed standard issue: the no-health-questions option many teaching hospitals have.
8 questions- What is a GSI disability insurance policy?GSI stands for guaranteed standard issue. It's a disability policy offered to residents and fellows at certain teaching hospitals that doesn't ask health questions.
- Should I apply for a medically underwritten policy before checking for GSI?No. Most GSI policies ask whether you've previously applied for disability insurance, and if you have, there's a good chance you won't be eligible.
- Can past mental health treatment affect getting disability insurance?Yes, with a medically underwritten policy it will come up. It's the most common item I see affect approval.
- What are the eligibility questions and limits of a GSI policy?Guardian's GSI asks whether you've applied for disability insurance before, whether you owe active-duty military time, whether you're collecting disability benefits from another source, and whether you've been actively at work for the past 180 days.
- I already applied for a medically underwritten policy. Can I still get GSI?Maybe. Having applied is the knockout question that disqualifies the most people, so there's a high likelihood you won't be eligible.
- Do GSI disability policies cost more?Not the ones I frequently come across. With the Guardian GSI, and with other companies too, there are no price increases or surcharges for getting the policy without health questions.
- Why can't my GME office tell me if there's a GSI policy?Because GSI policies are individual policies, not part of your hospital's benefits package.
- How do I tell a strong GSI policy from a scaled-back one?Check the definition of disability, the knockout questions, whether there's pre-existing conditions wording, the level of riders offered, the insurance company's financial strength, and whether it has a future increase option.
Choosing a policy
The wording and features that decide whether a policy actually pays.
7 questions- What is medical-specialty-specific true own-occupation disability insurance?It's the strongest definition of disability a policy can have.
- Is the group disability insurance from my employer enough?Usually not on its own. Group policies are often taxable, tied to your job and capped, and many use "any gainful occupation" wording.
- What is the future increase option on a disability policy?It lets you increase your coverage later, for example when you start earning attending pay, without answering health questions.
- How do I choose a disability insurance agent?Work with someone who specializes in physician disability insurance and can offer both GSI and medically underwritten policies.
- How much disability coverage can I get as an attending?Most physicians I work with are eligible for somewhere between $10,000 and $15,000 a month, depending on income and whether your employer gives you a group policy.
- What's the difference between short-term and long-term disability insurance?Short-term policies typically kick in after you've been out of work a week or two and may pay for a few months.
- What happens in medical underwriting, and can an exclusion be removed later?The insurer reviews your health history, medical records, prescriptions, billing codes and family history, then either covers you for everything, postpones or declines, or offers a policy with exclusions, ratings or modifications.
Medical school to residency
Student loans, taxes, housing and your first paycheck, from Jay's spring transition webinar.
9 questions- Disability insurance, student loans or a Roth IRA: what should I do first?Rank the topics for your own situation and work down the list.
- Should I file taxes as a fourth-year medical student with no income?Yes. When your loans come due, servicers link to your tax return to verify income.
- Should I do a direct consolidation before residency?Not necessarily, this year. In past years the usual advice was to consolidate right away to start the clock on PSLF.
- IBR or RAP: which repayment plan should I pick as a resident?For most graduating students these are the two options, and as a resident the monthly payments won't differ much.
- What do I need to qualify for Public Service Loan Forgiveness?Three boxes: the right kind of loans (government direct loans), the right kind of employer (government or nonprofit 501(c)(3)), and 120 qualifying payments.
- Should I refinance my student loans with a private lender as a resident?Rarely, right now. Refinancing government loans with a private lender permanently gives up PSLF and benefits like RAP's interest subsidy, and private rates may not be much lower today.
- Should I rent or buy during residency?It depends on how long your training is, where you matched, and what buying costs compared with renting there.
- Should I open a Roth IRA as a resident?It can be a wonderful retirement vehicle while you're earning resident money and expect to earn attending money later.
- How should I budget and build an emergency fund in intern year?Start from your take-home pay after taxes and insurance, list what you have to pay, and don't spend more than you make.
Life insurance
Term vs permanent, and when residents usually start looking.
1 question